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Establishing a National Chronic Kidney Disease Surveillance System for the United States

Rajiv Saran^*,, Elizabeth Hedgeman^*,, Laura Plantinga, Nilka Rios Burrows, Brenda W. Gillespie^,||, Eric W. Young^*,¶, Josef Coresh^**, Meda Pavkov, Desmond Williams, Neil R. Powe, and for the CKD Surveillance Team

^* Department of Internal Medicine, Kidney Epidemiology and Cost Center, and ^|| Center for Statistical Consultation and Research, University of Michigan, and ^¶ Veterans' Administration Ann Arbor Healthcare System, Ann Arbor, Michigan; Department of Medicine, San Francisco General Hospital and University of California, San Francisco, California; Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia; and ^** Departments of Epidemiology, Biostatistics, and Medicine, Johns Hopkins University, Baltimore, Maryland

Correspondence: Dr. Rajiv Saran,Division of Nephrology, Department of Internal Medicine, University of Michigan, and the Kidney Epidemiology and Cost Center, 315 West Huron, Suite 240, Ann Arbor, MI 48103-4262, Phone: 734-998-6611; Fax: 734-998-6620; E-mail rsaran{at}umich.edu

Despite the recognized importance of chronic kidney disease (CKD), the United States currently lacks a comprehensive, systematic surveillance program that captures and tracks all aspects of CKD in the population. As part of its CKD Initiative, the Centers for Disease Control and Prevention (CDC) funded two teams to jointly initiate the development of a CKD surveillance system. Here, we describe the process and methods used to establish this national CDC CKD Surveillance System. The major CKD components covered include burden (incidence and prevalence), risk factors, awareness, health consequences, processes and quality of care, and health system capacity issues. Goals include regular reporting of the data collected, plus development of a dynamic project web site and periodic issuance of a CKD fact sheet. We anticipate that this system will provide an important foundation for widespread efforts toward primary prevention, earlier detection, and implementation of optimal disease management strategies, with resultant increased awareness of CKD, decreased rates of CKD progression, lowered mortality, and reduced resource utilization. Final success will be measured by usage, impact, and endorsement.